Provider Demographics
NPI:1669412631
Name:BARNARD, CAROLINE G (PHD)
Entity type:Individual
Prefix:
First Name:CAROLINE
Middle Name:G
Last Name:BARNARD
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13331 N 56TH ST
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33617-1161
Mailing Address - Country:US
Mailing Address - Phone:813-644-7146
Mailing Address - Fax:813-644-7145
Practice Address - Street 1:13331 N 56TH ST
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33617-1161
Practice Address - Country:US
Practice Address - Phone:813-644-7146
Practice Address - Fax:813-644-7145
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-07
Last Update Date:2011-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY0002817103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL75813Medicare UPIN